Some providers and payers doubt whether managing online patient groups can impact patient care or the bottom line. But others, like the West County Health Centers network of Guerneville, Calif., are betting a new patient engagement model -- online groups hosted by its vendor WellFX -- will bring a return on investment. To achieve any results however, the first order of business for such a model is establishing strong HIPAA privacy and security policies.

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Jock Putney, WellFX CEO, explained the system was designed with HIPAA privacy and security laws in mind, unlike public-patient communities on the Web unaffiliated with health care providers that are more revenue-driven. Data moving through the network is encrypted and there are audit trails that document every bit of communication between patients and staff. Identity management tools for the host provider -- as well as for patients, who may reveal as much or as little of their own information to other group participants as they please -- help providers comply with HIPAA privacy and security laws.

Furthermore, Putney said, each provider client uploads his/her own educational materials for weight loss, diabetes management, etc., so there are no worries about sponsored, dated or just plain wrong content. That being said, WellFX is developing a shared library of health reference and tutorial information approved by its network of customers to exchange among themselves and upload to their online patient groups. Such filtering itself is a patient-engagement tool in itself, the company believes, because patients are more inclined to trust information vetted through their physicians as opposed to information of questionable origin they Googled on a health topic such as weight loss.

"We look at sites like EverydayHealth.com and WebMD.com, and there's a lot of stuff we don't think would make it into [WellFX's provider-approved content], I don't think they'd agree to that; we're seeing it now," said Putney, who is rolling out WellFX communities to several clinic groups. He also is in discussion with commercial payers, who are considering implementing groups for their insured patients. "Doesn't mean those sources are bad, or they have bad information. I just think providers are pretty finicky about what they want coming to their patient -- and I think the patient is more apt to trust it and follow it."

Learn It Live piloting online interactive classes

Other companies are also developing content and new ways to engage patients online, educate them and keep them focused on wellness between doctor visits. They hope to attract accountable care organization (ACO) customers to use their platforms as population health management tools.

I just think providers are pretty finicky about what they want coming to their patient -- and I think the patient is more apt to trust it and follow it.

Jock Putney, CEO, WellFX

One such company, Learn It Live.com, offers video courses and live, interactive online classrooms in subjects such as yoga, smoking cessation, stress management and nutrition. The classes can register up to 1,000 attendees at a time. They feature interactive blackboards, a virtual "microphone" where students can ask instructors questions, and chat platforms where students can message among themselves.

The company is currently setting up pilot programs for outcomes measurement and quantifying return on investment for providers. It plans to roll out provider-branded classrooms. Michael Frisbie, Learn It Live VP of business development, is sanguine that the pilots will prove ROI for health care providers -- which his company is seeking for participation in the pilots.

Frisbie said, watching Learn It Live's development so far, patient-to-patient interaction also appears to be a key driver for patients improving their health.

"A lot of people are focusing on webinars and recorded videos, whereas we are focused on the community, and providing people with live interaction, putting them together with their peers at the same time as the people they need to connect with," Frisbie said.

While WellFX and Learn It Live are still in early development, the simple idea of a provider-hosted and –controlled online wellness community intrigues Jeff Benabio, M.D., Kaiser Permanente dermatologist and physician director of health innovation, if outcomes research can validate their effectiveness.

"I think that's a much better model," he said. "With some safeties, with some regulation, you can still be patient-centric and have patients talking to each other, but yet have the protection of clinicians ensuring oversight," he said.

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